Validation of risk factors for recurrence of renal cell carcinoma: Results from a large single-institution series


Autoři: Johannes C. van der Mijn aff001;  Bashir Al Hussein Al Awamlh aff003;  Aleem Islam Khan aff003;  Lina Posada-Calderon aff003;  Clara Oromendia aff004;  Jonathan Fainberg aff003;  Mark Alshak aff003;  Rahmi Elahjji aff003;  Hudson Pierce aff003;  Benjamin Taylor aff003;  Lorraine J. Gudas aff001;  David M. Nanus aff005;  Ana M. Molina aff005;  Joseph Del Pizzo aff003;  Douglas S. Scherr aff003
Působiště autorů: Department of Pharmacology, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY, United States of America aff001;  Department of Medical Oncology, Amsterdam University Medical Center, Amsterdam, The Netherlands aff002;  Department of Urology, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY, United States of America aff003;  Department of Biostatistics and Epidemiology, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY, United States of America aff004;  Division of Hematology/Oncology, Department of Medicine, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY, United States of America aff005
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0226285

Souhrn

Purpose

To validate prognostic factors and determine the impact of obesity, hypertension, smoking and diabetes mellitus (DM) on risk of recurrence after surgery in patients with localized renal cell carcinoma (RCC).

Materials and methods

We performed a retrospective cohort study among patients that underwent partial or radical nephrectomy at Weill Cornell Medicine for RCC and collected preoperative information on RCC risk factors, as well as pathological data. Cases were reviewed for radiographic evidence of RCC recurrence. A Cox proportional-hazards model was developed to determine the contribution of RCC risk factors to recurrence risk. Disease-free survival and overall survival were analyzed using the Kaplan-Meier method and log-rank test.

Results

We identified 873 patients who underwent surgery for RCC between the years 2000–2015. In total 115 patients (13.2%) experienced a disease recurrence after a median follow up of 4.9 years. In multivariate analysis, increasing pathological T-stage (HR 1.429, 95% CI 1.265–1.614) and Nuclear grade (HR 2.376, 95% CI 1.734–3.255) were independently associated with RCC recurrence. In patients with T1-2 tumors, DM was identified as an additional independent risk factor for RCC recurrence (HR 2.744, 95% CI 1.343–5.605). Patients with DM had a significantly shorter median disease-free survival (1.5 years versus 2.6 years, p = 0.004), as well as median overall survival (4.1 years, versus 5.8 years, p<0.001).

Conclusions

We validated high pathological T-stage and nuclear grade as independent risk factors for RCC recurrence following nephrectomy. DM is associated with an increased risk of recurrence among patients with early stage disease.

Klíčová slova:

Cancer risk factors – Histology – Hypertension – Obesity – Renal cell carcinoma – Surgical and invasive medical procedures – Surgical oncology


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Článek vyšel v časopise

PLOS One


2019 Číslo 12